Print, Fill In and; Mail TO:
BUX Comm Inc
 115  Luenburg Drive
Evington,  VA 24550

 Internet: http://www.BUXCOMM.com

 To Print this ORDER FORM. CLICK HERE
OMoney Order / Check (included with mail order).
OCredit card*Include 3 digit number on back of card (_____)
VISA:*__ __ __ __|__ __ __ __|__ __ __ __|__ __ __ __
Discover:*__ __ __ __|__ __ __ __|__ __ __ __|__ __ __ __
MasterCard*__ __ __ __|__ __ __ __|__ __ __ __|__ __ __ __
Expiration Date, (required*)  Month:_____   Year: ______

This order can also be FAX'd to:
 1 434 525 4919

Name,  (first:                                               
(Initial):__ (last:                                          
Street:                                                          
City:                                                             
State:           ZIP: __________-______
Call:______Phone:                                    
Country:________________________
email:__________________________
Date:__________________________
Signature:                                                    

Order No.:

Part or Model/Description

 Quantity Price Each ($) TOTAL Price ($)
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
 

Virginia Residents, add 5% VA tax.

 $
   

Sub Total

 $
 

S&H

  
   

TOTAL

  

Shipping will be added according to weight chart below.  *Foreign orders will be charged according to carrier rates. 
The following rates apply to order shipped inside the continental USA; except Alaska:
Orders 0 to 1 pounds, $5.90 added to total.           Orders 1 to 2 pounds, $7.90 added to total. 
Orders 2 to 5 pounds, $9.90 added to total.           Orders 5 to 11 pounds, $11.90 added to total. 
Orders 11 to 15 pounds, $15.90 added to total.     Orders 15 to 40 pounds, $27.90 added to total.
Orders 40 to 50 pounds, $37.50 added to total.    To  Print this page. CLICK HERE